Guided waves, elastic waves propagating through bounded structures, play a pivotal role in various applications, including ultrasonic non-destructive testing and structural health monitoring. Recently, elastic metamaterials artificially engineered to exhibit physical properties not typically seen in nature have emerged as a ground-breaking approach, heralding a new era in guided wave-based technologies. These metamaterials offer innovative solutions to overcome the inherent constraints of traditional guided wave-based technology. This paper comprehensively reviews elastic metamaterials from their fundamental principles to diverse applications, focusing on their transformative impact in guided wave manipulation.